Priorities in Planning Hepatitis B and C Testing Services: New WHO Operational Guide

The World Health Organization (WHO) has released an operational guide on priorities in planning hepatitis B and C testing services. The purpose of this guide is to support countries in developing policies and practices that define a strategic mix of hepatitis B and C testing approaches, that are tailored to their unique situation and priorities ensuring an impactful national response to the hepatitis epidemic.

“Effective national strategic planning, funding and implementation of viral hepatitis testing services with linkage to care is critical in efforts to massively increase the number of people tested, diagnosed and treated,” says Dr Meg Doherty, Director of WHO Global HIV, Hepatitis and STI Programmes. “This guide is an essential tool for countries to operationalize current WHO recommendations."

In 2022, viral hepatitis, along with tuberculosis, was the second leading cause of death among communicable diseases globally, with deaths rising from 1.1 million in 2019 to 1.3 million. Hepatitis B and hepatitis C caused 83% and 17% of these deaths, respectively. Yet, by the end of 2022, only 13% of the estimated 254 million people living with hepatitis B had been diagnosed, and less than 3% had received antiviral treatment. Of the estimated 50 million people living with hepatitis C, 36% had been diagnosed between 2015 and 2022, and 20% had received curative treatment. These numbers underscore the critical role of effective testing as the first step to accessing life-saving prevention, care and treatment services.

This operational guide introduces a five-step framework for planning person-centred hepatitis B and C testing approaches, emphasizing a strategic mix of testing approaches, mobilization and demand creation, and streamlined linkage to care. It also highlights the importance of community leadership, health systems integration and quality assurance.

Dr Funmi Lesi, Team Lead, Global Hepatitis Programme, WHO, underlines that “Viral hepatitis testing services should be included in national essential health benefit packages, supported by adequate financing and coordinated actions to advance universal health coverage and integration in primary health care. Let us not forget that every person we diagnose with hepatitis is not just someone we need to treat but also an advocate and partner in advancing our hepatitis response.”

Importantly, the operational guide showcases success stories from 4 countries that have designed and executed effective testing approaches and strategies, illustrating remaining challenges and the key enablers of success.

Health policymakers, national hepatitis programme managers and community leaders are encouraged to adopt the strategic testing approaches and integration of services as outlined in this operational guide in efforts to stem the rising mortality from hepatitis B and C and achieve the goal of eliminating hepatitis as a public health threat by 2030.